title: Comorbidity between bipolar disorder and cluster B personality disorders as indicator of affective dysregulation and clinical severity.
abstract: BACKGROUND
  Several lines of evidence have well established a relationship between Bipolar Disorder and Cluster B Personality Disorders. The study compares mood spectrum and temperamental symptoms, personality traits and clinical characteristics among outpatients (n = 63) diagnosed with major depression (MD), bipolar disorder (BD), cluster B personality disorders (PD-B) and comorbidity of BD + PD-B.
  
  
  METHODS
  The diagnosis was determined with structured interviews (MINI and SCID II) and symptom assessments with evaluation and diagnostic instruments (MOODS-SR, BI, TEMPS-A and IPDE). Differences between groups were explored with post hoc analysis and analysis of variance.
  
  
  RESULTS
  Patients with BD+PD-B comorbidity presented an earlier onset and more severity in suicide attempts, hospitalizations and self-harm behaviors. They showed more characteristics of cyclothymic and irritable temperament and more cluster A and B personality traits, than patients with BD only. PD-B patients obtained intermediate scores in manic like symptoms: higher than patients with depression and lower than patients with bipolar disorder. However, the Bipolarity Index clearly distinguished patients with BD or with comorbidity (BD+PD-B) from the other diagnostic groups (PD-B and MD).
  
  
  CONCLUSIONS
  BD+PD-B comorbidity presents a more severe type of emotional dysregulation compared to the other diagnostic groups, including BD and PD-B alone. Assessing temperament, personality traits, emotional dysregulation in mania and depression, self-harm and hospitalizations severity and age onset could facilitate differential diagnosis and enhance effectiveness of treatments for BD, PD-B and their comorbidity.
authors.affiliation: Casa de Familia Córdoba, Argentina.
authors.forename: Sergio
authors.initials: S
authors.lastname: Apfelbaum
authors.forename: Pilar
authors.initials: P
authors.lastname: Regalado
authors.forename: Laura
authors.initials: L
authors.lastname: Herman
authors.forename: Julia
authors.initials: J
authors.lastname: Teitelbaum
authors.forename: Pablo
authors.initials: P
authors.lastname: Gagliesi
mesh_terms: D001714:Bipolar Disorder / Q000150:complications* / Q000175:diagnosis; D003865:Major Depressive Disorder / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D019964:Mood Disorders / Q000150:complications* / Q000175:diagnosis; D010554:Personality Disorders / Q000150:complications* / Q000175:diagnosis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires